1
|
Ebata Y, Sakaguchi Y, Tsuda Y, Nambara S, Kudou K, Kusumoto E, Yoshida R, Kusumoto T, Ikejiri K. A case of undifferentiated pleomorphic sarcoma in esophagus after multiple cancer treatments of surgery and chemoradiotherapy. Surg Case Rep 2022; 8:205. [PMID: 36333516 PMCID: PMC9636335 DOI: 10.1186/s40792-022-01560-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
Background Undifferentiated pleomorphic sarcoma (UPS) in the esophagus is extremely rare. Therefore, there are few reports of UPS in the esophagus (UPSE). We present a case of UPSE after multiple cancer treatments. Case presentation A 73-year-old man with a history of cancer treatment, including distal gastrectomy, transverse colectomy, and chemoradiotherapy, was diagnosed with an elevated lesion such as a submucosal tumor in the lower esophagus by regular endoscopy. A boring biopsy was performed, and the specimen showed features of sarcoma. The patient underwent a partial esophagectomy without lymph node dissection. Histopathological findings confirmed an undifferentiated pleomorphic sarcoma. Adjuvant therapy was not administered, and the patient survived without recurrence 1 year after surgery. Conclusions Currently, complete resection is the only treatment option for UPSE. An optimal treatment strategy using chemotherapy or radiotherapy should be established.
Collapse
Affiliation(s)
- Yuho Ebata
- grid.415613.4Department of Gastroenterological Surgery and Clinical Research Institute, Kyushu Medical Center, Jigyohama 1-8-1, Chuo-Ku, Fukuoka, 810-8563 Japan
| | - Yoshihisa Sakaguchi
- grid.415613.4Department of Gastroenterological Surgery and Clinical Research Institute, Kyushu Medical Center, Jigyohama 1-8-1, Chuo-Ku, Fukuoka, 810-8563 Japan
| | - Yasuo Tsuda
- grid.415613.4Department of Gastroenterological Surgery and Clinical Research Institute, Kyushu Medical Center, Jigyohama 1-8-1, Chuo-Ku, Fukuoka, 810-8563 Japan
| | - Sho Nambara
- grid.415613.4Department of Gastroenterological Surgery and Clinical Research Institute, Kyushu Medical Center, Jigyohama 1-8-1, Chuo-Ku, Fukuoka, 810-8563 Japan
| | - Kensuke Kudou
- grid.415613.4Department of Gastroenterological Surgery and Clinical Research Institute, Kyushu Medical Center, Jigyohama 1-8-1, Chuo-Ku, Fukuoka, 810-8563 Japan
| | - Eiji Kusumoto
- grid.415613.4Department of Gastroenterological Surgery and Clinical Research Institute, Kyushu Medical Center, Jigyohama 1-8-1, Chuo-Ku, Fukuoka, 810-8563 Japan
| | - Rintaro Yoshida
- grid.415613.4Department of Gastroenterological Surgery and Clinical Research Institute, Kyushu Medical Center, Jigyohama 1-8-1, Chuo-Ku, Fukuoka, 810-8563 Japan
| | - Tetsuya Kusumoto
- grid.415613.4Department of Gastroenterological Surgery and Clinical Research Institute, Kyushu Medical Center, Jigyohama 1-8-1, Chuo-Ku, Fukuoka, 810-8563 Japan
| | - Koji Ikejiri
- grid.415613.4Department of Gastroenterological Surgery and Clinical Research Institute, Kyushu Medical Center, Jigyohama 1-8-1, Chuo-Ku, Fukuoka, 810-8563 Japan
| |
Collapse
|
2
|
The Thousand Faces of Malignant Melanoma: A Systematic Review of the Primary Malignant Melanoma of the Esophagus. Cancers (Basel) 2022; 14:cancers14153725. [PMID: 35954389 PMCID: PMC9367585 DOI: 10.3390/cancers14153725] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 02/01/2023] Open
Abstract
Primary Malignant Melanoma of the Esophagus (PMME) is an extremely rare cancer of the esophagus, accounting for 0.1−0.8% of all oro-esophageal cancers and <0.05% of all melanoma subtypes, with an estimated incidence of 0.0036 cases per million/year. We conduct a careful analysis of the literature starting from 1906 to the beginning of 2022, searching the PubMed, Science.gov, Scopus and Web of Science (WoS) databases. A total of 457 records were initially identified in the literature search, of which 17 were duplicates. After screening for eligibility and inclusion criteria, 303 publications were ultimately included, related to 347 patients with PMME. PMME represents a very rare entity whose very existence has been the subject of debate for a long time. Over time, an increasing number of cases have been reported in the literature, leading to an increase in knowledge and laying the foundations for a discussion on the treatment of this pathology, which still remains largely represented by surgery. In recent times, the possibility of discovering greater mutations in gene hotspots has made it possible to develop new therapeutic strategies of which nivolumab is an example. Future studies with large case series, with clinicopathological and molecular data, will be necessary to improve the outcome of patients with PMME.
Collapse
|
3
|
Proboka G, Tilgase A, Isajevs S, Zablocka T, Olmane E, Rasa A, Alberts P. Adrenal Gland and Gastric Malignant Melanoma without Evidence of Skin Lesion Treated with the Oncolytic Virus Rigvir. Case Rep Oncol 2020; 13:424-430. [PMID: 32399011 PMCID: PMC7204777 DOI: 10.1159/000506978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/04/2020] [Indexed: 01/19/2023] Open
Abstract
Adrenal gland melanoma is an extremely rare diagnosis with less than 20 cases reported. The criteria for diagnosing adrenal gland melanoma include involvement of only one adrenal gland, presence of melanin pigment in the histological examination of the tumor tissue, no primary melanoma tumor in any other organ, and no history of resection of pigmented lesions. However, it is complicated to rule out melanoma of unknown primary origin. Here we report a female patient who at the age of 75 years was admitted to hospital due to suspicion of adrenal and gastric tumor. The largest tumor was found in the adrenal gland, thus leading to the diagnosis of primary adrenal gland melanoma presenting metastases in the stomach. The melanoma was BRAF wild type. Due to the rarity of this disease, there is no standard treatment. After two subsequent surgeries, treatment with the ECHO-7 oncolytic virus Rigvir was started. The patient has received oncolytic virotherapy for 5 years and 1 month and has been stable since then with good tolerability. The therapy is still ongoing. Adrenal gland melanoma is an extremely rare diagnosis and therefore it is important to discuss the diagnostic criteria and possible treatments.
Collapse
Affiliation(s)
- Guna Proboka
- Latvian Oncology Centre, Riga Eastern Clinical University Hospital, Riga, Latvia.,Rigvir, Riga, Latvia
| | | | - Sergejs Isajevs
- Department of Pathology, Riga Eastern Clinical University Hospital, Riga, Latvia.,Department of Pathology, Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Tatjana Zablocka
- Department of Pathology, Riga Eastern Clinical University Hospital, Riga, Latvia.,Department of Pathology, Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Evija Olmane
- Department of Radiology, Pauls Stradiņš Clinical University Hospital, Riga, Latvia
| | | | | |
Collapse
|
4
|
Yang CJ, Shai SE, Li WS, Hsu CP. A huge intraluminally growing polypoid tumor of the cervical esophagus: A case report and literature review of spindle cell (undifferentiated pleomorphic) sarcoma. FORMOSAN JOURNAL OF SURGERY 2013. [DOI: 10.1016/j.fjs.2013.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
5
|
Kawada K, Kawano T, Nagai K, Nishikage T, Nakajima Y, Tokairin Y, Ogiya K, Tanaka K, Iwai T. Local injection of interferon beta in malignant melanoma of the esophagus as adjuvant of systemic pre- and postoperative DAV chemotherapy: case report with 7 years of long-term survival. Gastrointest Endosc 2007; 66:408-10. [PMID: 17643724 DOI: 10.1016/j.gie.2006.05.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2005] [Accepted: 05/22/2006] [Indexed: 02/08/2023]
Affiliation(s)
- Kenro Kawada
- Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Dabrowski A, Zinkiewicz K, Szumilo J, Zgodzinski W, Cwik G, Skoczylas T, Wallner G. Unusual clinical course of metachronous melanomas of the upper digestive system. World J Gastroenterol 2005; 11:2197-9. [PMID: 15810093 PMCID: PMC4305796 DOI: 10.3748/wjg.v11.i14.2197] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Melanoma of the gastrointestinal tract is a rare, highly malignant neoplasm of poor prognosis. This is description of an unusual case of surgically treated patient with two metachronous malignant melanomas of the stomach and the esophagus. The former lesion was located in the cardia and effectively treated with R0 total gastrectomy. The latter was recognized after 67 mo and appeared as irregular, flat, pigmented areas located in the mid esophagus. Subtotal esophagectomy via right-sided thoracotomy, laparotomy and left-sided cervicotomy was performed, but neoplastic cells were found in distal margin (R1). Fourteen months after esophagectomy multiple lung metastases were detected. Patient died 2 mo later.
Collapse
Affiliation(s)
- Andrzej Dabrowski
- 2nd Department of General Surgery, Skubiszewski Medical University of Lublin, Staszica 16, 20-081, Lublin, Poland
| | | | | | | | | | | | | |
Collapse
|
7
|
Germano D, Rosati G, Romano R, Vita G, Lepore G, De Sanctis D, Manzione L. Primary gastric melanoma presenting as a double ulcer. J Clin Gastroenterol 2004; 38:828. [PMID: 15365416 DOI: 10.1097/01.mcg.0000139030.08074.da] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
|
8
|
Maesawa C, Iijima S, Sato N, Yoshinori N, Suzuki M, Tarusawa M, Ishida K, Tamura G, Saito K, Masuda T. Esophageal extraskeletal Ewing's sarcoma. Hum Pathol 2002; 33:130-2. [PMID: 11823984 DOI: 10.1053/hupa.2002.30219] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Extraskeletal Ewing's sarcoma is a rare tumor. The most common sites of occurrence are on the trunk, extremities, and retroperitoneum. This type of tumor is well characterized by recurrent chromosomal translocation such as t (11;22) (q24;q12) (EWSR1/FLI1) or t (21;22) (q22;q12) (EWSR1/ERG) and overexpression of MIC2/CD99 on tumor cell membrane. We describe the first reported case of an esophageal extraskeletal Ewing's sarcoma with confirmation from immunohistochemical and molecular diagnoses. A 56-year-old man developed a polypoid tumor located in the lower part of the esophagus. The tumor was composed of small-sized round cells showing prominent fibrillar cytoplasmic processes. Intracytoplasmic glycogen was detected in all the tumor cells. Immunoreactivity for MIC2/CD99 was positive on the membrane of all tumor cells. A reverse transcriptase-polymerase chain reaction followed by sequencing revealed an EWSR1/ERG chimeric transcript, which combined EWSR1 exon 10 with ERG exon 6. The present report added a new entity of esophageal small round cell tumor.
Collapse
Affiliation(s)
- Chihaya Maesawa
- Department of Pathology, Iwate Medical University School of Medicine, Morioka, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Li S. Pathologic quiz case: multiple pulmonary nodules with calcification. Arch Pathol Lab Med 2000; 124:1393-4. [PMID: 10975954 DOI: 10.5858/2000-124-1393-pqcauc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- S Li
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, USA
| |
Collapse
|
10
|
Visioli A, Daniel FJ. Leiomyosarcoma of the oesophagus: a case report and literature review of leiomyosarcoma. AUSTRALASIAN RADIOLOGY 1997; 41:160-5. [PMID: 9153814 DOI: 10.1111/j.1440-1673.1997.tb00704.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Leiomyosarcomas are uncommon tumours. Oesophageal leiomyosarcomas are even rarer. A case is presented of this rare tumour which on review of the literature seems to be the first patient surviving 22 years from the original treatment. We include a literature review of the clinical behaviour and management of leiomyosarcoma.
Collapse
Affiliation(s)
- A Visioli
- Peter MacCallum Cancer Institute, Melbourne, Australia
| | | |
Collapse
|
11
|
Pesarini AC, Ernst H, Ell C, Wittekind C, Hahn EG. [Leiomyosarcoma of the esophagus. Clinical aspects, diagnosis and therapy based on an individual case]. MEDIZINISCHE KLINIK (MUNICH, GERMANY : 1983) 1997; 92:234-40. [PMID: 9221308 DOI: 10.1007/bf03043265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Leiomyosarcomas of the esophagus are rare tumors of mesenchymal origin. Apropos of a case we present clinicopathological features, diagnostic procedures and management of this seldom tumor of the esophagus. Primary gastrointestinal sarcomas cause less than 0.5% of all esophageal malign tumors, and present in ca. 5% as esophageal leiomyosarcomas. The most frequent incidence ranges between the fourth and fifth decade of life. The tumors originate from the muscular layers of the esophageal wall and are localized predominantly in the middle and distal third of the esophagus. Dysphagia is the most important and leading symptom although it presents late in the course of the illness. Endosonography is at the time the most accurate method to establish the tumor size. Differentiation between leiomyoma and leiomyosarcoma is only possible by histopathological examination and may be difficult in certain cases. Histopathological grading of the tumors as low- and high-grade sarcomas in dependence of the number of mitosis affects predominantly the prognosis of these patients. Differential diagnosis includes spindle cell carcinoma and carcinosarcoma of the esophagus. The most effective therapy consists in the complete operative removal of the tumor, in these cases five years survival rates of 30 to 40% are achieved, strongly influenced by tumor differentiation and size.
Collapse
Affiliation(s)
- A C Pesarini
- Medizinische Klinik I mit Poliklinik, Universitat Erlangen-Nürnberg
| | | | | | | | | |
Collapse
|
12
|
Naganuma H, Ohtani H, Sayama J, Sakai N, Taira Y, Shibuya D, Miyazaki A, Sakurada H. Malignant fibrous histiocytoma of the esophagus. Pathol Int 1996; 46:462-6. [PMID: 8869999 DOI: 10.1111/j.1440-1827.1996.tb03638.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A 78-year-old man presented with an esophageal polyp that was confirmed by immunohistochemistry and electron microscopy to be malignant fibrous histiocytoma. The tumor was comprised of a proliferation of spindle-shaped cells admixed with bizarre giant cells. These tumor cells were immunoreactive for smooth muscle actin, vimentin, alpha-1-anti-chymotrypsin and CD68. Electron microscopic examination revealed the myofibroblastic and histiocytic features of the tumor cells. No elements of epithelial or myogenic differentiation were found in the tumor. Malignant fibrous histiocytoma of the esophagus is extremely rare, with 10 cases being documented so far in the literature. The differential diagnosis of pleomorphic tumors of the esophagus is discussed.
Collapse
Affiliation(s)
- H Naganuma
- Department of Pathology, Sendai City Hospital, Japan
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Affiliation(s)
- S Kinuya
- Department of Nuclear Medicine, Kanazawa University School of Medicine, Japan
| | | | | |
Collapse
|
14
|
|
15
|
Koga H, Iida M, Suekane H, Aoyagi K, Yao T, Kimura Y, Masuda N, Fujishima M. Rapidly growing esophageal leiomyosarcoma: case report and review of the literature. ABDOMINAL IMAGING 1995; 20:15-9. [PMID: 7894289 DOI: 10.1007/bf00199635] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We evaluated a 72-year-old woman who was experiencing dysphagia. Esophageal leiomyosarcoma was diagnosed by barium meal study, upper gastrointestinal endoscopy, endoscopic ultrasonography (EUS), by computed tomography (CT). A barium meal study and esophagoscopy performed 3 months before the diagnosis of esophageal leiomyosarcoma showed no abnormalities. Therefore, the tumor appeared to have grown rapidly during the 3-month period.
Collapse
Affiliation(s)
- H Koga
- Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Abstract
The clinical and pathologic characteristics of five patients with esophageal sarcomas are presented, including the only recorded esophageal Triton tumor (malignant schwannoma), the third recorded synovial sarcoma, two patients with carcinosarcoma, and one with leiomyosarcoma. All five patients were males who presented with dysphagia. Three tumors were in the cervical esophagus, and the remaining two were in the distal esophagus. On endoscopic examination, three of the tumors were noted to be polypoid, while the other two were sessile. Two patients presented with disseminated disease, and a third was locally unresectable. These three patients were treated with palliative intent. The remaining two patients underwent surgical excision and postoperative radiation therapy, and are alive and well 6 and 7 years following treatment. This experience suggests that combined modality therapy employing postoperative radiation may be effective in managing these rare lesions.
Collapse
Affiliation(s)
- S J Perch
- Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia
| | | | | | | |
Collapse
|